可溶性共刺激分子程序性死亡因子1表达与颈动脉粥样硬化斑块形成的相关性

目的探讨血清可溶性共刺激分子程序性死亡因子1（sPD-1）与颈动脉粥样硬化（CAS）斑块的相关性。 方法选择2016年1月至12月在上海市华东疗养院接受体检的69例CAS斑块患者作为CAS组，另外选择72名非CAS斑块者作为对照组，应用酶联免疫吸附试验检测所有研究对象的血清sPD-1的浓度。采用t检验比较2组受检者血清sPD-1的差异，采用Pearson或Spearman法分析血清sPD-1与临床各指标［年龄、性别、吸烟、饮酒、体质量指数（BMI）、腰臀比、收缩压、舒张压、三酰甘油、总胆固醇、低密度脂蛋白胆固醇（LDL-c）、高密度脂蛋白胆固醇（HDL-c）、糖化血红蛋白（HbA1c）、脂蛋白a、空腹血糖］的相关性以及CAS组中斑块Crouse积分与各指标的相关性，采用二元Logistic回归对CAS斑块行危险因素分析；使用ROC曲线分析sPD-1预测CAS斑块形成的诊断价值。 结果CAS组sPD-1水平高于对照组［（1.26±1.01）μg/L vs （0.64±0.49）μg/L］，差异具有统计学意义（t=4.598，P<0.001）；sPD-1与BMI、腰臀比、三酰甘油、空腹血糖、HbA1c呈正相关（P<0.05），与HDL-c、脂蛋白α呈负相关（P<0.05）；斑块Crouse积分与年龄、SBP呈正相关（P<0.05），与TG呈负相关（P<0.05）；年龄、性别、饮酒、LDL-c、舒张压sPD-1是CAS斑块形成的危险因素；ROC曲线分析显示sPD-1对于颈动脉粥样硬化斑块形成有中等诊断价值（P<0.05）。 结论sPD-1可能在CAS斑块的形成、发展的炎症过程中发挥作用，sPD-1对预测CAS斑块形成有诊断价值。

Association between serum soluble costimulatory molecule programmed cell death-1 and carotid atherosclerosis

ObjectiveTo investigate the association between serum soluble costimulatory molecule programmed death factor 1 (sPD-1) and carotid atherosclerosis (CAS). MethodsSixty-nine patients with CAS plaques who underwent physical examination at Shanghai Huadong Sanatorium from January to December 2016 were selected as a study group (CAS group), and another 72 patients without CAS plaques were selected as a control group. Enzyme-linked immunosorbent assay was used to detect the concentrations of serum sPD-1. The t-test was used to compare the difference of serum sPD-1 between the two groups. Pearson or Spearman method was used to analyze the correlations of serum sPD-1 with age, gender, smoking, alcohol consumption, body mass index (BMI), waist hip ratio (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), triacylglycerol (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), glycosylated hemoglobin (HbA1c), lipoprotein a [Lp(a)], and fasting blood glucose (FBG). Pearson or Spearman method was also used to analyze the correlation between plaque Crouse score and various indicators in the CAS group. The risk factors for CAS plaque were identified by binary Logistic regression analysis. Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic value of sPD-1 in predicting CAS plaque formation. ResultsThe concentration of sPD-1 in the CAS group was significantly higher than that in the control group ([1.26±1.01] μg /L vs [0.64±0.49] μg/L, t=4.598, P<0.001). SPD-1 was positively correlated with age, BMI, WHR, TG, FBG, and HbA1c (P<0.05), and negatively correlated with gender (male as the reference), HDL-c, and LP(a) (P<0.05). Plaque Crouse score was positively correlated with age and SBP (P<0.05), and negatively correlated with TG (P<0.05). Age, drinking, LDL-c, and sPD-1 were identified to be risk factors for CAS plaque formation. ROC curve analysis showed that sPD-1 had medium diagnostic value for carotid atherosclerotic plaque formation (P<0.05). ConclusionsPD-1 may play a role in the formation and development of CAS plaques, and it has appreciated diagnostic value in predicting the formation of CAS plaques.